| NPI | 1811910532 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A109067) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CT 047652) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: LA MD203183) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CO DR-48266) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME104649) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD428543) | |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2026-02-18 |